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• Nationality
• -- Nationality -- AFGHANISTAN ALBANIA ALGERIA AMERICAN SAMOA ANDORRA ANGOLA ANGUILLA ANTARCTICA ANTIGUA AND BARBUDA ARGENTINA ARMENIA ARUBA AUSTRALIA AUSTRIA AZERBAIJAN BAHAMAS BAHRAIN BANGLADESH BARBADOS BELARUS BELGIUM BELIZE BENIN BERMUDA BHUTAN BOLIVIA BOSNIA AND HERZEGOWINA BOTSWANA BOUVET ISLAND BRAZIL BRITISH INDIAN OCEAN TERRITORY BRUNEI DARUSSALAM BULGARIA BURKINA FASO BURUNDI CAMBODIA CAMEROON CANADA CAPE VERDE CAYMAN ISLANDS CENTRAL AFRICAN REPUBLIC CHAD CHILE CHINA CHRISTMAS ISLAND COCOS (KEELING) ISLANDS COLOMBIA COMOROS CONGO COOK ISLANDS COSTA RICA COTE D'IVOIRE CROATIA (local name: Hrvatska) CUBA CYPRUS CZECH REPUBLIC DENMARK DJIBOUTI DOMINICA DOMINICAN REPUBLIC EAST TIMOR ECUADOR EGYPT EL SALVADOR EQUATORIAL GUINEA ERITREA ESTONIA ETHIOPIA FALKLAND ISLANDS (MALVINAS) FAROE ISLANDS FIJI FINLAND FRANCE FRANCE, METROPOLITAN FRENCH GUIANA FRENCH POLYNESIA FRENCH SOUTHERN TERRITORIES GABON GAMBIA GEORGIA GERMANY GHANA GIBRALTAR GREECE GREENLAND GRENADA GUADELOUPE GUAM GUATEMALA GUINEA GUINEA-BISSAU GUYANA HAITI HEARD AND MC DONALD ISLANDS HONDURAS HONG KONG HUNGARY ICELAND INDIA INDONESIA IRAN (ISLAMIC REPUBLIC OF) IRAQ IRELAND ISRAEL ITALY JAMAICA JAPAN JORDAN KAZAKHSTAN KENYA KIRIBATI KOREA, DEMOCRATIC PEOPLE'S REP OF (NORTH KOREA) KOREA, REP OF (SOUTH KOREA) KUWAIT KYRGYZSTAN LAO PEOPLE'S DEMOCRATIC REPUBLIC LATVIA LEBANON LESOTHO LIBERIA LIBYAN ARAB JAMAHIRIYA LIECHTENSTEIN LITHUANIA LUXEMBOURG MACAU MACEDONIA, THE FORMER YUGOSLAV REPUBLIC OF MADAGASCAR MALAWI MALAYSIA MALDIVES MALI MALTA MARSHALL ISLANDS MARTINIQUE MAURITANIA MAURITIUS MAYOTTE MEXICO MICRONESIA, FEDERATED STATES OF MOLDOVA, REPUBLIC OF MONACO MONGOLIA MONTSERRAT MOROCCO MOZAMBIQUE MYANMAR NAMIBIA NAURU NEPAL NETHERLANDS NETHERLANDS ANTILLES NEW CALEDONIA NEW ZEALAND NICARAGUA NIGER NIGERIA NIUE NORFOLK ISLAND NORTHERN MARIANA ISLANDS NORWAY OMAN PAKISTAN PALAU PANAMA PAPUA NEW GUINEA PARAGUAY PERU PHILIPPINES PITCAIRN POLAND PORTUGAL PUERTO RICO QATAR REUNION ROMANIA RUSSIAN FEDERATION RWANDA SAINT KITTS AND NEVIS SAINT LUCIA SAINT VINCENT AND THE GRENADINES SAMOA SAN MARINO SAO TOME AND PRINCIPE SAUDI ARABIA SENEGAL SEYCHELLES SIERRA LEONE SINGAPORE SLOVAKIA (Slovak Republic) SLOVENIA SOLOMON ISLANDS SOMALIA SOUTH AFRICA SOUTH GEORGIA AND THE SOUTH SANDWICH ISLANDS SPAIN SRI LANKA ST. HELENA ST. PIERRE AND MIQUELON SUDAN SURINAME SVALBARD AND JAN MAYEN ISLANDS SWAZILAND SWEDEN SWITZERLAND SYRIAN ARAB REPUBLIC TAIWAN TAJIKISTAN TANZANIA, UNITED REPUBLIC OF THAILAND TOGO TOKELAU TONGA TRINIDAD AND TOBAGO TUNISIA TURKEY TURKMENISTAN TURKS AND CAICOS ISLANDS TUVALU UGANDA UKRAINE UNITED ARAB EMIRATES UNITED KINGDOM UNITED STATES UNITED STATES MINOR OUTLYING ISLANDS URUGUAY UZBEKISTAN VANUATU VATICAN CITY STATE (HOLY SEE) VENEZUELA VIET NAM VIRGIN ISLANDS (BRITISH) VIRGIN ISLANDS (U.S.) WALLIS AND FUTUNA ISLANDS WESTERN SAHARA YEMEN YUGOSLAVIA ZAIRE ZAMBIA ZIMBABWE

• Residing Country
• 458

• Identification No. *
• e.g. 791231102345

• Date of Birth *
• Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 Your next renewal date will be your birth month

• Gender *
• Male Female

• Ethnicity *
• ---- Please Select ----- Bumiputera Chinese Indian Others

Ensure that you have entered your mobile number correctly in order to receive your OTP (One Time Password). OTP is needed to authenticate certain transactions.

• Mobile Phone No. *
• --- 010 011 012 013 014 015 016 017 018 019
  eg.0102323232

• Other Phone No. (Optional)
• 673
  eg.0322345678

Make sure your email address is correct. Your new Cosway Member ID and password and any correspondence about your account will go to this address.

• Email Address *

• Re-enter Email Address *

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• Broadcast Subscription - News & Updates
• Yes, I would like to receive news and updates from Cosway

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• Yes, I would like to receive Member's Special Offers newsletter from Cosway.

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• Address line 1 *

• Unit Number/ Floor/ Building Name

• Address line 2

• Address line 3

• Street Address

• State *
• -- State -- JOHOR KEDAH KELANTAN MELAKA NEGERI SEMBILAN PAHANG PENANG PERAK PERLIS SABAH SARAWAK SELANGOR TERENGGANU WP KUALA LUMPUR WP LABUAN WP PUTRAJAYA

• City *
• -- City --

• Post Code *

• Password *

• (8 characters, alpha-numeric)

• Re-enter Password *

• (8 characters, alpha-numeric)

  IMPORTANT: To make your password more secure, mix letters and numbers. Please DO NOT use letters or numbers that are repetitive or in a predictable sequence e.g. 11111111, abcdefgh, abcd1234.Password is not case sensitive.

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Membership Terms & Conditions

• I have read, understood and agree to abide by the terms set forth in The Membership Agreement Terms & Conditions & Cosway Privacy Notice.* In the event details provided by the applicant are found to be incomplete, inaccurate, invalid, false and/or forged, Cosway reserves the right to terminate the application.*

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